Factors Influencing Lymph Node Positivity in HER2/neu+ Breast Cancer Patients

Abstract

Axillary lymph node metastases are a key prognostic factor in breast cancer treatment. Our aim was to evaluate how tumor size, tumor location, and imaging results correlate to axillary lymph node diseases for patients with stage I-III HER2/neu+ breast cancer. This is a single-institution retrospective chart review of female breast cancer patients diagnosed with primary invasive Her2/neu+ breast cancer who were treated with upfront surgical resection from 2000–2021. Of 75 cases, 44/75 (58.7%) had nodal metastasis, and there was a significant association of larger tumor size to nodal metastases (p ≤ 0.001). Patients with negative nodes had a smaller mean tumor size (n = 30; 15.10 mm) than patients with positive nodes (n = 45; 23.9 mm) (p = 0.002). Preoperative imaging detected suspicious nodes in 36 patients, and ultrasound detected the most positive nodes (14/18; p = 0.027). Our data confirms that tumor size at diagnosis is correlated with a higher likelihood of axillary involvement in patients with Her2/neu+ breast cancer; notably, a large proportion of Her2/neu+ breast cancers have metastatic involvement of axillary lymph nodes even with small primary lesions.

Factors Predictive of Positive Lymph Nodes for Breast Cancer

“…The mean age at diagnosis was 53.5 (range 21-85). IDC was the most common diagnosis (97.3%) and most patients had T1 disease (62.7%) [12] Most patients had histologic grade 3 (62.7%) disease, and 20% had lymphovascular invasion. Out of 47 T1 patients, 21 were positive for nodal metastasis (44.7%), a larger percentage compared to other subtypes (Figure 2).…”